A little background...
I admitted a patient at the end of my shift Monday. From home with hospice, admitting dx UTI/sepsis/hematuria. He's 91, baseline non-ambulatory, very minimal verbal response, at times combative.
Plan of tx was abx, okay, I can see how that goes with comfort/hospice care, I'm on board, all is well.
Then, before I left Monday I get an order to initiate CBI, oh and can we draw another CBC since his Hgb went from 10.9 to 7.9?
Also we are doing a complete retroperitoneal UTS, which is, in and of itself relatively non-invasive, but what treatments will we do if we find something?
Now to my favorite part...
I had him again today and based on report, physician's notes, consults, and orders the care team is on board with him being comfort care/non-invasive measures. All of the care team, except his wife/POA/primary caregiver.
Denial is more than just a river in Egypt y'all.
She stormed out of a meeting with the palliative team, slamming the door, after death was mentioned. She INSISTED that he be given a diet order and spent all day yesterday and today force-feeding him.
No one is allowed to mention death or speak negatively within his earshot.
Today he was even starting to mottle but, "why aren't we giving him his cardizem and the other 9 (NINE!) vitamins that she gives him every day?
Tonight his IV went bad and his abx were switched to PO so of course I crushed them and mixed them is custard (what she happened to be force-feeding him at the moment).
I said "Mr. Smith, here is a bite with your antibiotic in it, would you like to open your mouth and take it?"
He cracked his lips open enough for me to slide the spoon in.
I put the rest of the custard/antibiotic on the spoon; "Mr. Smith, here's the rest, would you like to open your mouth for the rest?"
Nothing. I touched the spoon to his lips...nothing.
His wife became agitated, started trying to convince him that he MUST take the medicine.
I explained (again) that he has the right to refuse medications and that, perhaps, he has decided he is okay with the consequences of not taking them.
Her words (verbatim) were, "he doesn't understand the consequences...I don't tell him when there is medicine...I never tell him. If he knows there is medicine in it he won't take it...come on Dad, you've got to take it. I know it doesnt taste good, but no medicine does. You've just got to grin and bear it. How do you think women have babies? They just grin and bear it."
And then when he still refused to take it she burried her heas in her hands and with teary eyes said, "dinner was going so well! Oh, it was going so well!"
She's upset that when he d/c tomorrow he will be back under the care of hospice instead of home health 
Y'all, I promise I'm a good nurse, and I'm truly not heartless, but you know some days there's that one person...
Libby1987
3,726 Posts
Not our call to make but I view it as selfish and weak, it's neither love nor advocacy when the family prolong and/or add to the suffering. I feel for the OP.